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BRES2021-0803BUILDING PERMIT DESIGN & DEVELOPMENT DEPARTMENT 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 Permit Type: Building Residential Permit Number: BRES2021-0803 Property Address: 53325 HUMBOLDT BLVD APN: 767700013 Legal Description Property Zoning: RL Valuation: $872,259.30 PHONE (760) 777-7125 WWW.LAQUINTACA.GOV APPLIED DATE: 11/15/2021 ISSUED DATE: 05/11/2022 CALIFORNIA Owner: MOONBEAM DREAMS LLC 27412 ALISO VIEJO PRKWY, ALISO VIEJO, CA 92656 Applicant: Karl Voigtlander 910 west st, Oceanside, CA 92054 Contractor: Jon Foster 555 CORPORATE DR STE 120, LADERA RANCH, CA 92694 PRIOR TO THE ISSUANCE OF THIS PERMIT FOR CONSTRUCTION, ALTERATION, IMPROVEMENT, DEMOLITION, OR REPAIR THE OWNER, APPLICANT AND/OR CONTRACTOR UNDER PENALTY OF PERJURY HAVE AFFIRMED WHEN APPLICABLE, THROUGH THE SUBMITTAL OF FORMS OR BY OTHER ELECTRONIC MEANS, THE FOLLOWING: LICENSED CONTRACTOR OR OWNER -BUILDER DECLARATION (1 or 2) 1) They are licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and the referenced License is in full force and effect, or; 2) That they are exempt from the Contractors' State License Law for the reason(s) indicated by either (2)(a) and/or (2)(b), or (2)(c) where he or she is exempt from licensure by a valid exemption. [Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code] Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).) a) As owner of the property, or my employees with wages as their sole compensation, will do all of or portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.). b) As owner of the property, will be exclusively contracting with licensed c) Are exempt from licensure under the Contractors' State License Law. As an Owner -Builder, they acknowledge that, except for their personal residence in which they must have resided in for at least one year prior to completion of the improvements covered by this permit, they cannot legally sell a structure built as an owner -builder if it has not been constructed in its entirety by licensed contractors. It is understood that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application was submitted at the following Web site: http://www.Ieginfo.ca.gov/calaw.htm1. DECLARATION REGARDING CONSTRUCTION LENDING AGENCY (If applicable) A construction lender will be used for completion of the improvements covered by this permit and the name and information of which is on file for public inspection during the regular business hours of the public entity. Failure of the applicant to indicate the construction lender on the WORKERS' COMPENSATION DECLARATION (1, 2 or 3) WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1) Has and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2) Has and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 3) Certifies that, in the performance of the work for which this permit is issued, shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, shall forthwith comply with those provisions. NOTICE TO APPLICANT (1, 2 and 3) 1) Each person upon whose behalf this application was made, each person at whose request and for whose benefit work is being performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2) Any permit issued as a result of this application becomes null and void if work is not commenced within 360 days from date of issuance of such permit, or if cessation of work for 180 days will subject permit to cancellation. On or after January 1, 2019, every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 12 months after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period of 12 months after the time the work is commenced. 3) Certified that they read the application and state that the information provided is correct. Agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above -mentioned property for inspection purposes. IMPORTANT: An Application for Permit was made to the Building Official, subject to the conditions and restrictions set forth at the time of application, which is now hereby an Issued Permit. If any part of the information being supplied on this permit is inaccurate or untrue, please contact the City of La Quinta at (760) 777-7125 immediately for correction. Printed: 11/20/25 9:47 am Page 1 of 8 BUILDING PERMIT Permit Type: Building Residential Permit Number: BRES2021-0803 Property Address: 53325 HUMBOLDT BLVD application does not relieve that person of the requirement to give the construction lender preliminary notice from that duty. Printed: 11/20/25 9:47 am Page 2 of 8 BUILDING PERMIT Permit Type: Building Residential Permit Number: BRES2021-0803 Property Address: 53325 HUMBOLDT BLVD MOONBEAM DREAMS / 10,144SF DWELLING/VB/RES-3/CLASS A-FR/13D *** 10,144SF DWELLING - LOT 61 [VB/RES-3/CLASS A-FR/13D] THIS PERMIT DOES NOT INCLUDE POOL, SPA, BLOCK WALLS OR DRIVEWAY APPROACH (RES STRUCTURAL). 2019 CALIFORNIA BUILDING CODES. #111# MOONBEAM DREAMS / 10,144SF DWELL ING/VB/RES-3/CLASS A-FR/13D ... REVISION 1 ADDITION OF NEW ELECTRICAL ROOM FOR RELOCATION OF MAIN SERVICE ELECTRICAL PANEL WITHIN APPROVED BUILDING AREA, FENESTRATION ALTERATIONS (2), AND ALTERNATE FIREPLACES THROUGHOUT [RES STRUCTURAL]. 2019 CALIFORNIA BUILDING CODES. #111# MOONBEAM DREAMS / 10,144SF DWELLING/VB/RES-3/CLASS A-FR/13D '— REVISION 2 ADDITION OF SPLIT HVAC SYSTEMS AT GARAGE AND STORAGE AREAS WITH INSULATION ADDED AT GARAGE. 2019 CALIFORNIA BUILDING CODES. #111# MOONBEAM DREAMS / 10,144SF DWELLING/VB/RES-3/CLASS A-FR/13D ... REVISION 3 ADDITION OF LAUNDRY ROOM IN GUEST BED 2 AREA, RELOCATION OF ALTERNATE FIREPLACES AT GREAT ROOM AND MASTER BEDROOM, EXPANSION OF PANTRY WITH NEW SINK, EXPANSION OF REC. ROOM BAR, RECONFIGURATION AT HALLWAY,OFFICE AND GOLF SIMULATOR AREAS, REVISED FENESTRATION VALUES, AND RELOCATION OF HVAC CONDENSER UNITS TO SCREENEE ROOF TOP ABOVE ENTRY. NO ADDITIONS TO CONDITIONED SPACE. 2019 CALIFORNIA BUILDING CODES. ninstructien DPt2 Residential Work Type Dwelling - Single Family Conditioned Square 10144 Garage Square 1661 Detached Footage Footage Patio Square Footage 1276 Fire Sprinkler Square 11805 Construction Type V-B Footage Code Edition 2019 Number of Floors 1 Number of Bedrooms 6 Number of Units 1 Building/Unit Occupancy Classification(s) Number of Flag or 0 New Electrical Square Light Pole(s)? Footage Temporary Power Yes Miscellaneous Service? Electrical Number of Air 9 Number of Ventilation Handling Unit(s) Fan(s) Miscellaneous 1 Number of Plumbing Mechanical Fixtures/Traps Number of Water 2 Water System Install Heater(s) or Alteration? Sewer Connection? Yes Zoning R-3: 1 & 2 Family Grading Required? Yes, New Dwelling Dwellings, U: Utility/Misc Structures 13081 Electrical Service? Yes 3 Number of 9 Condenser(s) 11 Number of Exhaust 1 Hood(s) 41 Number of Roof Drains 19 Yes Number of Gas 11 Outlet(s) RL Type Group Sq Ft Value Printed: 11/20/25 9:47 am Page 3 of 8 Permit Type Building Residential BUILDING PERMIT Permit Number: Property Address BRES2021-0803 53325 HUMBOLDT BLVD Invoice No. Fee Fee Amount Amount Paid PERM IT-BRES2021-080 CONDENSER/COMPRESSOR PC $250.11 $250.11 3 NEW CONSTRUTION - SINGLE FAMILY RESIDENTIAL $161.00 $161.00 RESIDENTIAL, EA ADDITIONAL 1,000SF $184.21 $184.21 DIF - CIVIC CENTER $1,230.00 $1,230.00 RESIDENTIAL, FIRST 1,000SF PC $55.02 $55.02 PARTIAL INSPECTION FEE $87.53 $87.53 2.5 CREDIT CARD PROCESSING FEE $10.94 $10.94 NEW CONSTRUCTION PERMIT 2021 $4,971.32 $4,971.32 ROOF DRAIN $263.91 $263.91 FIRE NEW RESIDENTIAL $83.00 $83.00 WATER HEATER/VENT $27.78 $27.78 BUILDING SEWER PC $19.45 $19.45 GAS SYSTEM, 5+ OUTLETS PC $27.78 $27.78 RE -INSPECTION FEE $83.37 $83.37 HOURLY CHARGE - INTERWEST STRUCTURAL PLAN REVIEW $312.50 $312.50 PLAN CHECK DEPOSIT - RESIDENTIAL $437.65 $437.65 DIF - PARK IMPROVEMENTS $2,106.00 $2,106.00 AIR HANDLER $375.12 $375.12 2.5 CREDIT CARD PROCESSING FEE $2.19 $2.19 RESIDENTIAL, FIRST 1,000SF $166.73 $166.73 FIXTURE/TRAP PC $569.49 $569.49 2.5 CREDIT CARD PROCESSING FEE $12.92 $12.92 SMI - RESIDENTIAL $113.39 $113.39 EXHAUST HOOD $13.89 $13.89 HOURLY CHARGE - CITY BUILDING STAFF $350.00 $350.00 PARTIAL INSPECTION FEE $87.53 $87.53 DIF - TRANSPORTATION $4,009.00 $4,009.00 TECHNOLOGY ENHANCEMENT FEE $5.00 $5.00 HOURLY CHARGE - INTERWEST STRUCTURAL PLAN REVIEW $62.50 $62.50 CONDENSER/COMPRESSOR $375.12 $375.12 DIF - COMMUNITY CULTURAL $956.00 $956.00 OTHER MECHANICAL EQUIPMENT PC $41.68 $41.68 DIF - LIBRARY $397.00 $397.00 HOURLY CHARGE - INTERWEST STRUCTURAL PLAN REVIEW $312.50 $312.50 2.5 CREDIT CARD PROCESSING FEE $16.56 $16.56 VENT FAN PC $61.16 $61.16 WATER HEATER/VENT PC $16.68 $16.68 HOURLY CHARGE - CITY BUILDING STAFF $350.00 $350.00 BSAS SB1473 FEE $35.00 $35.00 HOURLY CHARGE - CITY BUILDING STAFF $167.00 $167.00 RESIDENTIAL - CUSTOM HOME >7KSF PC $208.41 $208.41 OTHER MECHANICAL EQUIPMENT $41.68 $41.68 ROOF DRAIN PC $263.91 $263.91 VENT FAN $152.79 $152.79 RE -INSPECTION FEE $83.37 $83.37 HOURLY CHARGE - CITY BUILDING STAFF $83.50 $83.50 Printed: 11/20/25 9:47 am Page 4 of 8 BUILDING PERMIT Permit Type: Building Residential Permit Number: BRES2021-0803 Property Address: 53325 HUMBOLDT BLVD GAS SYSTEM, 5+ OUTLETS $41.68 $41.68 FIRE NEW RESIDENITIAL PC $83.00 $83.00 ART IN PUBLIC PLACES - RESIDENTIAL $1,680.64 $1,680.64 TUMF 2021 - SINGLE FAMILY DWELLING $2,358.00 $2,358.00 RESIDENTIAL, EA ADDITIONAL 1,000SF PC $75.92 $75.92 2.5 CREDIT CARD PROCESSING FEE $16.56 $16.56 FIXTURE/TRAP $569.49 $569.49 RECORDS MANAGEMENT FEE - MAJOR $21.00 $21.00 EXHAUST HOOD PC $5.56 $5.56 DIF - FIRE PROTECTION $369.00 $369.00 AIR HANDLER PC $125.01 $125.01 PLAN CHECK DEPOSIT - RESIDENTIAL $175.06 $175.06 BUILDING SEWER $27.79 $27.79 RESIDENTIAL - CUSTOM HOME >7KSF $41.68 $41.68 NEW CONSTRUCTION PLAN CHECK 2021 $3,086.26 $3,086.26 HOURLY CHARGE - CITY BUILDING STAFF $87.50 $87.50 DIF - MAINTENANCE FACILITIES $313.00 $313.00 Total for Invoice PERMIT-BRES2021-0803 $28,718.84 $28,718.84 Grand Total for Permit $28,718.84 $28,718.84 Workflow Step / Action Name Action Type Start Date End Date Inspections v.1 11/15/2021 0:00 ---------------------------------------------------------------------------------------------------------------------------------------- DRYWALL NAIL v.4 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- DRYWALL NAIL v.3 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- INSULATION v.5 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- LATH v.4 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- DRYWALL NAIL v.2 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- INSULATION v.4 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- INSULATION v.3 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- LATH v.3 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- ROUGH ELEC v.2 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- ROUGH PLBG v.2 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- ROUGH MECH v.2 Inspection ---------------- - - - - - - OKAY TO WRAP v.5 Inspection ......................................................................... FRAMING v.4 Inspection -- -- -- -- -- -- -- --............................................................................................................ FRAMING v.3 Inspection -- - - - - - - - - - - - - - - - - - - - -- - DRYWALL NAIL v.1 Inspection ---------------------------------------------------- LATH v.2 Inspection ---------------------------------------------------- LATH v.1 ------------------------------------------------------------------------------------ Inspection ---------------------------------------------------- OVERHEAD ROUGH PIPING v.2 ------------------------------------------------------------------------------------ Inspection ---------------------------------------------------------------------------------------------------------------------------------------- ROUGH MECH v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- ROUGH PLBG v.1 Inspection --------------------- -- -- -- -- -- -- -- -- FRAMING v.2 Inspection ROUGH ELEC v.1 Inspection Printed: 11/20/25 9:47 am Page 5 of 8 BUILDING PERMIT Permit Type: Building Residential Permit Number: BRES2021-0803 Property Address: 53325 HUMBOLDT BLVD FRAMING v.1 Inspection -------------------- INSULATION v.2 -------- Inspection ----------------------------------------------------- SHOWER PAN v.2 --------------------------- Inspection ------------------------------------------------------ ROOF NAIL v.7 -------------------------------------------------------------------------------- - Inspection ------------------------------------------------------------------------------------ ROOF DRAIN v.3 --------------------------------------------- --- --- Inspection ------------------------------------------------------------------------------------ ROOF DRAIN v.2 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ SHOWER PAN v.1 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ ROOF NAIL v.6 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ ROOF DRAIN v.1 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ OVERHEAD ROUGH PIPING v.1 ---------------------------------------------------- Inspection ------------------------------------------------------------------------------------ UNDERGROUND PLBG v.7 ---------------------------------------------------- Inspection --------------------------------------------------------------------------------------------------------------------------------------- INSULATION v.1 Inspection ----------------------------------------------------- UNDERGROUND PLBG v.6 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- OKAY TO WRAP v.4 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- UNDERGROUND PLBG v.5 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- ROOF NAIL v.5 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- OKAY TO WRAP v.3 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- ROOF NAIL v.4 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- OKAY TO WRAP v.2 --------------------------- Inspection ----------------------------------------------------- ROOF NAIL v.3 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- ROOF NAIL v.2 --------------------------- Inspection ----------------------------------------------------- ROOF NAIL v.1 --------------------------- Inspection ----------------------------------------------------- OKAY TO WRAP v.1 --------------------------- Inspection ----------------------------------------------------- DEFERRED TRUSS v.1 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- SEWER CONNECTION v.1 ---------------------------------------------------------------------------------- Inspection ----------------------------------------------------- FOOTINGS v.3 --------------------------- Inspection ----------------------------------------------------- SLAB v.3 --------------------------- Inspection ------------------------------------------------------------------------ FOOTINGS v.2 ------------------------------------------------------------- - Inspection ------------------------------------------------------------------------------------ SLAB v.2 ---------------------------------------------------- Inspection ---------------------------------------------------------------------------------------------------------------------------------------- FOOTINGS v.1 Inspection ------------------------------------------------------------------------------------ SLAB v.1 --------------------------------------------- --- --- Inspection ---------------------------------------------------------------------------------------------------------------------------------------- UNDERGROUND ELEC v.1 Inspection ------------------------------------------------------------------------------------ UNDERGROUND PLBG v.4 --------------------------------------------- --- --- Inspection ---------------------------------------------------------------------------------------------------------------------------------------- UNDERGROUND PLBG v.3 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- UNDERGROUND PLBG v.2 Inspection --------------------- -- - --------------------------------------------------------------------------------------------------------------- UNDERGROUND PLBG v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- TEMPORARY POWER v.1 Inspection Deferred Submittals v.1 11/14/2023 12:29 ----------------------------------------------------- Linked Solar Permit v.1 ---------------------------------------------------------------------------------- Create Sub Permit ----------------------------------------------------- Linked Fire Sprinkler Permit v.1 ---------------------------------------------------------------------------------- Create Sub Permit 11/14/2023 12:29 04/18/2024 13:32 Application Completeness Check v.1 ----------------------------------------------------- Confirm Fees Paid v.1 ---------------------------------------------------------------------------------- Generic Action ----------------------------------------------------- Submittal Document Verification v.1 -------------------------------------------------------------------------------- Generic Action Plan Check v.1 Printed: 11/20/25 9:47 am Page 6 of 8 BUILDING PERMIT Permit Type: Building Residential Permit Number: BRES2021-0803 Property Address: 53325 HUMBOLDT BLVD Building Major Review v.1 Receive Submittal Permit Issuance v.1 --------------------------------------------------------------------------------------------------------------------------------------- Contractor / Owner -Builder Information v.1 Generic Action --------------------------------------------------------------- Verify & Invoice Fees v.1 ----------------------------------------------------------------------- - Generic Action --------------------------------------------------------------- Ready to Issue v.1 ----------------------------------------------------------------------- - Generic Action ---------------------------------------------------------------------------------------------------------------------------------------- Verify Fee Payment & Issue Permit v.1 Generic Action ---------------------------------------------------------------------------------------------------------------------------------------- Print, Attach, and Email Building Permit v.1 Create Report Inspections - Do Not Pour Concrete Until Approved v.1 ---------------------------------------------------------------------------------------------------------------------------------------- Setbacks v.1 Inspection ---------------- -- -- -- -- -- - Underground Plumbing v.1 -------------------------------------------- Inspection ------------------------------------------------------------------------ Water Line v.1 -- -- -- -- -- -- -------------------------------------------- Inspection --------------------------------------------------------------------------------------------------------------------------------------- Footing v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- Slab v.1 Inspection Inspections - Cover No Work Until Approved v.1 11/08/2023 0:00 --------------------------------------------------------------------------------------------------------------------------------------- Roof Nail v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- Okay to Wrap v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- Framing v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- Rough Electrical v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- Rough Mechanical v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- Rough Plumbing v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- Rough Fire Clearance v.1 Generic Action --------------------------------------------------------------------------------------------------------------------------------------- Shower Pan v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- Insulation v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- Drywall Nail v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- Exterior Lath v.1 Inspection --------------------------------------------------------------------------------------------------------------------------------------- Gas Test v.1 Inspection 11/08/2023 0:00 11/09/2023 10:26 ------------------------------------------------------------------------------------------------------------------------------ Sewer Connection v.1 -------- Inspection I Inspections - Masonry v.1 Inspections - Electrical for Meter Release v.1 09/22/2023 16:20 ---------------------------------------------------------------------------------------------------------------------------------------- Temporary Power v.1 Inspection ---------------------------------------------------------------------------------------------------------------------------------------- Temp Use of Permanent Power v.1 Inspection 09/22/2023 16:20 09/25/2023 10:36 Inspections - Final v.1 11/15/2023 16:56 04/23/2024 10:27 ---------------------------------------------------------------------------------------------------------------------------------------- Final Fire v.1 Inspection 11/16/2023 14:39 11/17/2023 15:04 ---------------------------------------------------------------------------------------------------------------------------------------- Final Fire v.2 Inspection 04/18/2024 13:33 04/18/2024 13:34 ---------------------------------------------------------------------------------------------------------------------------------------- Final Building v.1 Inspection 11/15/2023 16:56 11/16/2023 13:44 -------------------------------------------------------------------------------------------------------------------------------------- Final Building v.2 Inspection 11/16/2023 16:42 11/17/2023 - 15:07 --------------------------------------------------------------------------------------------------------------------------------------- Final Building v.3 Inspection 11/17/2023 16:15 11/20/2023 15:12 --------------------------------------------------------------------------------------------------------------------------------------- Final Building v.4 Inspection 04/22/2024 0:00 04/23/2024 10:27 Certificate of Occupancy v.1 04/23/2024 16:41 04/23/2024 16:42 --------------------------------------------------------------------------------------------------------------------------------------- Certificate of Occupancy v.1 Create Report 04/23/2024 16:41 04/23/2024 16:42 Printed: 11 /20/25 9:47 am Page 7 of 8 BUILDING PERMIT Permit Type: Building Residential Permit Number: BRES2021-0803 Property Address: 53325 HUMBOLDT BLVD Construction or work for which a permit is required shall be subject to inspection by the building official and such construction or work shall remain visible and able to be accessed for inspection purposes until approved. Approval as a result of an inspection shall not be construed to be an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Inspections presuming to give authority to violate or cancel the provisions of the applicable code and other ordinances of the jurisdiction shall not be valid. It shall be the duty of the owner or the owner's authorized agent to cause the work to remain visible and able to be accessed for inspection purposes. Neither the building official nor the jurisdiction shall be liable for expense entailed in the removal or replacement of any material required to allow inspection. It shall be the duty of the holder of the building permit or their duly authorized agent to notify the building official when work is ready for inspection. It shall be the duty of the permit holder to provide access to and means for inspections of such work that are required by this code. A building or structure shall not be used or occupied in whole or in part, and a change of occupancy of a building or structure or portion thereof shall not be made, until the building official has issued a certificate of occupancy therefor as provided herein. Issuance of a certificate of occupancy shall not be construed as an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Certificates presuming to give authority to violate or cancel the provisions of this code or other ordinances of the jurisdiction shall not be valid. A person shall not make connections from a utility, a source of energy, fuel, or power, or a water system or sewer system to any building or system that is regulated by the applicable code and other ordinances of the jurisdiction for which a permit is required, until approved by the buildinq official. Printed: 11/20/25 9:47 am Page 8 of 8 CAL FIRE - RIVERSIDE UNIT RIVERSIDE COUNTY FIRE DEPARTMENT �Cv BILL WEISER - FIRE CHIEF OFFICE OF THE FIRE MARSHAL — LA QUINTA CALIFORNIA 495 Calle TampicoELa ❑uinta❑C 9225 • Phone _._0❑❑❑a❑D❑4 . ❑❑❑.rvc1h'e.org November 28, 2021 Moonbeam Dreams LLC 27412 Aliso Viejo Pkwy Aliso Viejo, CA 92656 Re: Residential Fire Access & Water Plan Review — MADISON CLUB — LOT 61 BRES2021-0803 / 53325 HUMBOLDT BLVD, LA QUINTA, CA 92253 The plans you submitted for the above referenced project have been reviewed by Riverside County Fire Department - Office of the Fire Marshal personnel and are approved with the following conditions. 1) Property/Unit Addressing shall be provided. Minimum 4-inch-tall numbers of contrasting color to their background shall be displayed on the structure and viewable from the roadway or posted at the driveway entrance and maintained visible. 2) The proposed structure requires a fire flow of 1,500 gallons per minute from a single hydrant located within 600-feet of all exterior portions of the structure. (CFC 507.5.1 & APPENDIX B) 3) Dwelling Units shall maintain a minimum 3-feet clear width Egress Court from emergency escape windows and doors of sleeping rooms and shall deposit to the front of the property or public way. (Ref. CBC 1028.4 / CRC R311.1) 4) A Residential Fire Sprinkler system shall be installed in compliance with CRC R313. CA Licensed Contractor (C-16) shall submit plans and details for review and approval prior to system installation and Rough Inspections. The Fire Department approved plans and conditions letter must be at the job site. Applicant shall be responsible to contact the Fire Department to schedule inspections. Requests for inspections are to be made at least 48 hours in advance and may be arranged by calling (760)777-7131. All questions regarding the meaning of these conditions should be referred to the Office of the Fire Marshal staff at (760)777-7074. Kohl Hetrick - Fire Safety Specialist T4t!t 4 4Q" DESIGN & DEVELOPMENT DEPARTMENT 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 (760) 777-7125 FAX (760) 777-7011 1V[CIM—wel STREET ADDRESS OF JOB: 53325 HUMBOLDT BLVD APN: 779-440-013 DESCRIPTION OF WORK: NEW SINGLE-FAMILY DWELLING SQUARE FOOTAGE: 10,144 OWNER'S NAME: MOON BEAM DREAMS, LLC OAFl"S_lll1;fo1y/11:0fez ]_1.1ZA %\'1 ALISO VIEJO, CA 92656 For questions regarding this letter, please contact: City of La Quinta Permit Center (760) 777-7125 Coachella Valley Unified School District 83-733 Avenue 55 P 0 Box 847 Thermal, CA 92274 (760) 398-5909 Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 CITY OF LA QUINTA BUILDING DIVISION REVIEWED FOR CODE COMPLIANCE DATE 03/17/2022 BY�D C Please note: This letter verifies conditioned square footage. Please call your School District to verify school fees, requirement for cashier's check or money order and hours of operation. Coachella Valley Unified School District 83-733 Avenue 55, Thermal, CA 92274 (760) 398-5909 — Fax (760) 398-1224 This Box For District Use Only DEVELOPER FEES PAID AREA. AMOLM 1I> 11 ONE ANOLM LEM TWO AMOUNT mn QATTON AMOUNT I C010WIND AMOUtft DATE RECEIFr CHECK r R7rrtAt,S CERTIFICATE OF COMPLIANCE (California Education Coda 17620) Project Name: Madison Club Date: April 20, 2022 Owner's Name: Moon Beam Dreams, LLC Phone No. 949-855-9111 Project Address: 53325 Humboldt Blvd., LaQuinta Project Description: SFD APN: 779A40-013 Tract #; Lot #'s: Type of Development: Residential X X Commercial Industrial Total Square Feet of Building Area: 10,144 sq. ft. Certification of Applieant/Owners; The person signing certifies that the above information is correct and makes this statement under penalty of perjury and further represents that he/she is authorized ty�gn on behalf of the owner/developer. Dated: April 20, 2022 Signature: ilk — SCHOOL as:ttsaekk**#+sts#sit*•s**k#t*s#s###*#*s#s•##s*aa#tss#tkkkk#***ta#ka### DISTRICT'S REQUIREMENTS FOR THE ABOVE PROJECT HAVE BEEN OR W 1 LL BE SATISFIED IN ACCORDANCE WITH ONE OF THE FOLLOWING: (CIRCLE OirE) Education Code 17620 Number of Sq.Ft. Amount per S+Ft. Amount Collected Gov. Code 65995 Commercial 10144 S4.08 S41387.52 Building Permit Application Completed: Yes/No By: Laurie Howard Project Agreement Existing Not Subject to Fee Approval Prior to 1/1/87 Requirement Note: Pursuant to AB 181 any room additions or enclosures of 500 sq. ft. or less are exempt from developer fees. Any mobile homes being relocated within the same school district's jurisdiction are exempt from developer fees. Certificate issued by: Laurie Howard, Administrative Spec. Signature: �% s�-�� l L? �'%� �t NOTICE OF 90 DAY PERIOD FOR PROTEST OF FEES AND STATEMENT OF FEES Section 66020 of the Government Code asserted by Assembly Sal 3081, effective January 1, 1997, requires that this District provide (1) it written notice to the project appellant, at the time of payment of school fees, mitigation payment or other exactions ("Fea ), or the 90-day period to protest the imposition of these Fees and (2) the amount of the feu Therefore, is accordance with section 66020 of the Government code and other appliabit law, this Notice shall serve to advise you that the 90-day protest period in regard to such Fees or The validity, thereof, commences with the payment of the fees or performance of may other requiremtats u described in section 66020 of the Government code. Additionally, the amount of the fees imposed is as herein set forth, whether payable at this time or In whole or In part prior to issuance of a Certificate orotcupauey. As in The latter, the 90 days starts on the date bereof. This Certificate of Compliance is valid for thirty (30) days from the date of Issuance. Extension wilt be granted only for good cause, as determined by the School District, and up to throe (3) such extetutons may be granted. HIV of couil+,wo: tu,m updated MOW 11/2010 T"dY 4 4a" DESIGN & DEVELOPMENT DEPARTMENT 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 (760) 777-7125 FAX (760) 777-7011 CERTIFICATION OF BUILDING AREA STREET ADDRESS OF JOB: 53325 HUMBOLDT BLVD APN: 779-440-013 DESCRIPTION OF WORK: NEW SINGLE-FAMILY DWELLING SQUARE FOOTAGE: 10,144 OWNER'S NAME: MOON BEAM DREAMS, LLC 27412 ALISO VIEJO PARKWAY ALISO VIEJO, CA 92656 For questions regarding this letter, please contact: City of La Quinta Permit Center (760) 777-7125 Coachella Valley Unified School District 83-733 Avenue 55 P O Box 847 Thermal, CA 92274 (760) 398-5909 Desert Sands Unified School District 47-950 Dune Palms Road La Quinta, CA 92253 (760) 771-8515 CITY OF LA QUINTA BUILDING DIVISION REVIEWED FOR CODE COMPLIANCE 1 ATr 03/17/2022 ,v'D C Please note: This letter verifies conditioned square footage. Please call your School District to verify school fees, requirement for cashier's check or money order and hours of operation. DEFERRED TRUSS SUBMITTAL REQUEST Date: 02/01/2022 Permit Application Number: BRES202IL-0803 Project Street Address: 53325 HUMBOLDT BLVD Applicant: Karl Voigtlander Policy Conditions and Acknowledgment: zLimited to Custom Residential Prefabricated Wood Trussed Roof Projects W 0"&a CALIFORNIA — Submittal Package Shall Consist of Electronically Stamped and Signed Truss Calculations with Engineer of Record's Acceptance and a Roof Truss Layout P1City Anticipated Initial Review Time is Ten (10) Working Days with Rechecks of Five (5) Workings Days WlFee for Plan Review and Processing will be the Actual Hourly Cost Incurred by the City Consultant and the Hourly Cost per the Applicable Fee Schedule for City Staff WlApproval and Payment of Fees are Required Prior to Request for Roof Nail Inspection, No Exceptions By signing this form, the applicant agrees to, and will be solely responsible for any delays incurred by not complying with, the timelines, conditions, and requirements as identified. Signature: for i 0 I City Staff CITY OF LA QUINTA Approved By: BUILDING DIVISION REVIEWED FOR CODE COMPLIANCE r 03/17/2022 _, -D C WILLIAM DOUGLASS 760-366-0791 SPECIAL INSPECTION REPORT INSPECTION TYPE CONTINUOUS PERIODIC XXX DATE(S) Non Structural Steel Canopy 10/31 thru 11/3/22 PHYSICALADDRESS (INCLUDE STREET NAME AND CITY) PERMIT# S332S Humboldt Blvd. - La Quinta JOB NAME (INCLUDE NAME OF COUNTRY CLUB I BUSINESS PARK I CORPORATE CENTER I LOT NUMBER... ECT) Moonbeam Dreams (Lot 6113) @ The Madison Club ARCHITECT ENGINEER Mark Radford RES Struct GENERAL CONTRACTOR SUBCONTRACTOR Genova Construction Palm Springs Welding DISCREPANCIES DESCRIPTION OF WORK INSPECTED 10/31 - Observed fit up & start of welding of non-structural courtyard canopy as follows: TS6xl8xl/4 main beams & TS2x8xl/8 cross beams NOTE 1: Only welding south end of TS2x8 to north side of TS6x18 in north most bay & north end of TS2x8 to south side of TS6x18 in south most bay. All other ends of TS2x8 shop welded. Also mid span TS6x18's that run parallel with TS2x8's shop welded south end at south bay and north end at north bay. 11/1 - Observed field welding of non-structural courtyard canopy as follows: - TS6x18 to TS6x18 & TS2x8 to TS6x18 NOTE 2: At 4 corner where TS6x18 connect to TS6x18. Only 3 sides welded. Welding of vertical side against shear panel not possible. Contractor states he has spoken with engineer about this condition and given verbal ok to omit outside vertical weld at all 4 corners. 11/2 - Observed field welding of non-structural courtyard canopy as follows: - TS6x18 to TS6x18 & TS2x8 to TS6x18 11/3 - Observed completion of welding of all areas of non-structural courtyard canopy. Welders Certs on file - F.C.A.W. (3 Welders) NOTE: Full plan review not performed and additional Special Inspections may be required. Plans provided stamped city approved 4/29/2022 TO THE BEST OF MY KNOWLEDGE, WORK INSPECTED WAS IN ACCORDANCE WITH THE BUILDING DEPARTMENT APPROVED PLANS AND SPECIFICATION UNLESS NOTED ABOVE William Roy Douglass _!�2`"- INSPECTORS SIGNATURE ICC 1111326 INSPECTORS CERTIFICATION AGENCY AND NUMBER Building Permit Number: Project Description: SFR Exempt: ❑ (Materials may contain hazardous wastes and are not subject to recycling provisions) Construction Debris Management Plan Plan Submittal Date Job Site Address Owner's Name Number, Street, or PO Box City, State, Postal Code Owner's Phone Number Owner's E-Mail Address Project Manager's Name Project Manager's Phone Number Project Manager's E-mail Address Builder / Contractor Number, Street or PO Box City, State, Postal Code Project Square Footage 53325 Humboldt Bouldevard, La Quinta, CA 92253 Moonbeam Dreams, LLC 27 Journey, Ste 100 Aliso Viejo, CA 92656 949-285-2395 Iwellman(@centon.com Josh Hunter 949-887-2486 Josh(@GenovaCD.com Genova Construction and Development 555 Corporate Drive, Ste 120 Ladera Ranch, CA 92694 10,144 SQ/FT City Approval By 11P_ Date of City Approval 05/06/2022 Materials To Be Discarded: Product Trash Asphalt Brick/Block Cardboard Commingled Concrete Drywall Donated / Reuse* *Describe Items Tons Not recyclable Product Recyclable Masonry (broken) Recyclable Plaster Recyclable Scrap Metal Recyclable Tile (floor) Recyclable Tile (roof) Recyclable Wood Recyclable Landscape Debris Tons Recyclable Recyclable Recyclable Recyclable Recyclable Recyclable Recyclable 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Totals: Recycle Trash 0.0 0.0 Projected Diversion: #DIV/0! I understand it is the property owner's responsibility to submit copies of weight tickets or receipts to the District Environmental Coordinator as these hauls occur. I hereby certify that completion, implementation and adherence of the Debris Management Plan (DMP) for the above named project shall guarantee that at least 65% of the jobsite waste is diverted from Iandfilling. The remaining material will be recycled or reused. I will divert, for recycling or re -use, remaining materials generated from the first day of the project through the completion of the project in accordance with this plan. This DMP is issued in the name of the property owner(s) and shall remain their property throughout the construction and/or demolition project. A contractor serving as agent of the owner may obtain a DMP for the owner. However, the DMP is still issued in the name of the property owner(s) and the owner retains legal responsibility for ensuring that the provisions of the DMP are adhered to. The property owner(s) and general contractor shall be kept informed of the diversion progress through bi-monthly reports. If self -hauling, all refuse material from this project site must be taken to an approved recycler or transfer Owner / Developer / Project Manager / Superintendant Date Construction Debris Management Plan Summary of Requirements As of January 1, 2017, The Green Building Standards Code (CALGreen) requires that the construction of most new structures in the State of California comply with sections 4.408 and 5.408 of the code in accordance with Assembly Bill 939 requiring that no more than 35% of jobsite waste be disposed of as trash at local land fill sites and transfer stations. Exceptions may be made for certain projects under certain conditions. The City of La Quinta is committed to the highest level of environmental respect, to conserving our precious natural resources and setting an example to provide for a better world for generations to come. Recycling helps keep reusable resources out of landfills and will also reduce disposal costs. IMPORTANT: Burrtec Waste & Recycling Services is the City's franchise hauler. If you choose to self -haul any recyclables or trash, you must provide copies of all weight tickets and/or receipts from the transfer station, landfill, or recycler as the job progresses. Clean-up companies and other haulers are not permitted to haul waste or recyclables from the City of La Quinta. Self -haul weight tickets should be submitted to: Mike Veto, Municipal Services Director - mveto@burrtecdesert.com, or faxed to (760) 340-0417, or mailed to: 41575 Eclectic Street, Palm Desert, CA. 92260. CITY OF LA QUINTA - PUBLIC WORKS DEPARTMENT GREEN SHEET PUBLIC WORKS CLEARANCE FOR RELEASE OF BUILDING PERMIT Form updated & effective 9/25/2009 Green Sheet approvals are forwarded to the Building & Safety Department directly by Public Works. Please DO NOT submit the Green Sheet (Public Works Clearance) Packet to the Public Works Department until ALL requirements listed below are complete. Incomplete applications or applications which cannot be processed will be returned to applicant. Date: 2 / 1 / 22 Developer: Genova Construction & Development Tract No.: 33076-2 Tract Name: Address(s): 53325 HUMBOLDT BLVD Lot No.(s):61 Phone Number: ( ) (949) 429-0243 The following are the requirements for Public Works Clearance to authorize issuance of a building permit from the Building & Safety Department: ❖ CUSTOM HOMES: PROVIDE ITEMS #2, #3, #4, #5 & #7 BELOW ❖ TRACT HOMES: PROVIDE ITEMS #1, #2, #3 & #5 BELOW ❖ COMMERCIAL BUILDINGS/OTHER: PROVIDE ITEMS #1, #2, #3, #5 & #7 BELOW ❖ WALLS, SIGNS, OTHER: PROVIDE ITEM #6 BELOW 1. Attach Pad Elevation Certificates in compliance with the approved design elevation for building pad (maximum allowable deviation of +/- 0.1 foot). Pad Elevation Certificates must be current (within 6 months of current date). If a precise grading plan creates the pad for approval, please withhold green sheet submittal until a Pad Elevation Certificate can be provided. 2. Attach geotechnical certification of grading plan compliance including compaction reports from a licensed Soils Engineer. Recently rough graded residential developments which have a previously approved geotechnical certification are exempt from this requirement. 3. Attach recorded final map or title information/grant deed showing proposed building locations are legal lots. 4. Complete the attached <1 acre per lot or infill project Fugitive Dust Control project information form, PM10 plan & agreement or provide alternative & valid City approved PM10 plan set reference number or hard copy plan. PM10 plans for commercial & residential developments (beyond 1 lot) are submitted separately with grading plans & are subject to additional requirements. A current PM10 certification number is required. 5. Attach a copy of the rough or precise grading plan to the Public Works Department showing building location(s) for pad elevation verification. AO flood zone developments will require an approved flood plain development plan. 6. Attach supporting documentation for wall plan, monument sign, grease trap or special facility installations. 7. Complete and sign the attached water quality management plan (WQMP) exemption form, if applicable. PW approved building construction projects require either a WQMP or a completed WQMP exemption form. Approved maps/plans may be viewed at the following link: http://www.la-guinta.org/PlanCheck/m search.aspx I have reviewed and confirmed the requirements listed above as presented and find the improvements to be sufficiently complete for construction of the proposed buildings/structures/walls/signs on the subject Iot(s). Pursuant to my findings, the above project may be released for building permit issuance. This section completed by City staff. Recommended by: Date: Public Works Distribution: ( ) Green Sheet to Building & Safety ( ) Green Sheet to Planning Department Declined for approval for reason(s) as follow(s), please correct and resubmit: T:\Checklists - Forms & Applications\Forms & Applications\GREEN SHEET cover & PM10 less than 1 Acre Revised 9-25-09.doc City of La Quinta - PM10 Fugitive Dust Control Project Information Construction Phase PM10 Agreement (<1 acre/lot or Infill Project) Project Information Project Contractor: Genova Construction & Development Project Phase (check one) Construction Demolition Project Name: MADISON CLUB LOT 61 B Project Tract/Lot Numbers: 33076-2 / LOT 61 Project Street Address: 53325 HUMBOLDT BLVD LA QUINTA Total Acres in Active Construction (<1 acre per Lot):.82 Anticipated Start Date: 2 / 1 / 22 Anticipated Completion Date: 2 / 1 / 22 PM10 Contact Information Please note: Dust control is required 24 hours a day, 7 days a week, regardless of construction status. Person listed below is responsible for dust control during business and non -business hours. Name: Joshua Hunter Title: President Company Name: Genova Construction & Development Mailing Address: 555 Corporate Dr., Suite 120 City, State, ZIP Code: Ladera Ranch, CA 92694 Primary Phone #: (949) 429-0243 Fax #: (888) 221-1646 24 Hour Emergency Phone#: (949) 887-2486 Cell Phone #: (949) 887-2486 Email Address: josh@genovacd.com PM10 Certificate #: The above stated property owner (or authorized representative): ❖ Shall act as his/her acknowledgement of dust control requirements and their enforceability, pursuant to SCAQMD Rules 403, 403.1, 401, 402, 201, 203 and PERP; ❖ Shall constitute an Agreement to comply with all project conditions as identified in the approved dust control plan. ❖ Acknowledges that dust control is required twenty-four (24) hours a day, seven (7) days a week, throughout the period of project performance, regardless of project size or status; ❖ Shall ensure that each and every contractor, subcontractor and all other persons associated with the project shall be in continuous compliance with all requirements of the approved dust control plan; ❖ Shall take all necessary precautions to minimize dust, even if additional measures beyond those listed in the dust control plan are necessary; ❖ Shall authorize representatives of City/County to enter the property for inspection and/or abatement purposes; ❖ Shall hold harmless the Cityr-ounty and its representatives from liability for any actions related to this dust control plan or amity/County joitifted abatement activities. 41n4 l�/lam 1, 1, zQ 12 Signatur rope or ANSb4ed Representative Date T:\Checklists - Forms & Applications\Forms & Applications\GREEN SHEET cover & PM10 less than 1 Acre Revised 9-25-09.doc City of La Quinta - PM10 Fugitive Dust Control Plan (<1 acre per Lot or Infill Project) This Fugitive Dust Control Plan shall take into account applicable SCAQMD Regulations Rule 403, 403.1, 401, 402, 201, 203 and Portable Equipment Registration Program (PERP). ❖ WATERING: Continuous watering is required to prevent dust and must occur a minimum of four (4) times daily. Water shall be applied from an adequate sized metered water source to dry soils to prevent: ■ Visible dust emissions >20% opacity ■ Visible dust emissions that travel >100 feet from the source (within site) ■ Visible dust emissions that cross any property line ❖ EDUCATION: The responsible dust control Individual and key personnel shall attend SCAQMD PM10 class and obtain PM10 certificate number prior to construction activity (training information may be obtained by contacting SCAQMD at (909) 396-2183). ❖ CONSTRUCTION & DEMOLITION ACTIVITIES: A copy of this approved Fugitive Dust Plan must be kept on site. At least one short-term stabilization method must be used during off hours. At least one long-term stabilization measure must be used within ten (10) days of ceasing activity. ❖ WEATHER MONITORING: Wind predictions shall be monitored. ❖ SIGNAGE: Approved signs shall be installed at a highly visible location. Please refer to the Coachella Valley Fugitive Dust Control Plan Handbook for Construction Signage Guidelines. ❖ TRAFFIC: Construction traffic shall not be allowed on the pad, unless absolutely necessary. If vehicles operate on pad, pad shall be kept firm and moist through hose watering and sprinklers; and a maximum traffic speed of 15mph will be enforced. Fugitive Dust shall be prevented by fencing off site to prevent unauthorized traffic on pad. ❖ PARKING: Parking is not allowed on pad. All vehicles must park on street at designated areas only. ❖ TRACK OUT: Provide 24 hour street cleaning and track out system as approved by City Public Works inspectors. No dirt on public or private roads. Track out shall be cleaned up within one (1) hour of incident and at the conclusion of each workday. ❖ DIRT PILES: Dirt piles shall be limited to 50 cubic yards and built per California Building Code grading requirements. Piles shall be kept moist or covered with tarp material. Larger dirt piles will require stockpile or grading permit. ❖ FENCING: Provide PM10 fencing at perimeter of public roads and where applicable. Wood slat fencing can be installed at rear of property and return 20 feet on either side if HOA restrictions apply. Block walls can replace PM10 fencing during the construction phase. ❖ EQUIPMENT: Extra hoses and sprinklers shall be maintained on site. ❖ EXCAVATION MEASURES: All areas to be excavated or graded shall be pre -watered. Water shall also be applied during excavation or grading operations. ❖ DUMP TRUCKS: Open top dump trucks shall be wet down, moist and covered with a tarp prior to leaving site. ❖ INACTIVE SITE: Within 10 days of ceasing of activities, re -vegetate or permanently stabilize as required. ❖ RECORD KEEPING: Fugitive Dust Control Plan records (i.e. self inspection records, records of use of chemical suppressants, etc.) shall be maintained for 3 years by the Property Owner (or Authorized Representative). Property Owner shall notify the City and SCAQMD within 10 days of completion of project. T:\Checklists - Forms & Applications\Forms & Applications\GREEN SHEET cover & PM10 less than 1 Acre Revised 9-25-09.doc Water Quality Management Plan (WQMP) Exemption Form - Whitewater River Region Documentation of Project Not Requiring a WQMP but Requiring Site Design BMPs and Source Control BMPs by Entitlement Conditions of Approval or Permit Conditions — WQMP Required for the Listed Change of Land Uses or for Changes of Pollutant Stream (All Questions Below Must be Answered "No" To Exempt Project) Yes No Entitlement or construction of new single-family hillside residence(s) that create 10,000 square feet, or more, of impervious area where the pre -development natural slope is 25% orgreater? ❑ RI Entitlement or construction of new single-family hillside residence(s) that create 10,000 square feet, or more, of impervious area where the pre -development natural slope is 10% or greater where erosive soil conditions are known? ❑ ❑✓ Entitlement or construction of new commercial and industrial development(s) of 100,000 square feet or more? ❑ Entitlement or construction of new automotive repair shop(s) including body, upholstery, paint, exhaust, tire, transmission, engine or other automotive specialty repair. [Standard Industrial Classification SIC codes 5013, 7532, 7533, 7534, 7537, 7538, and 75391? ElFv Entitlement or construction of new retail gasoline outlets disturbing greater than 5,000 square feet? ❑ ❑� Entitlement or construction of new restaurant(s) (or potential restaurant shell space) disturbing greater than 5,000 square feet? ❑ ❑ Entitlement or construction of new home subdivisions with 10 or more housing units? ❑ Entitlement or construction of new parking lot(s) of 5,000 square feet or more, or with 25 or more parking spaces, and potentially exposed to Urban Runoff. ❑ Applicant Information Name and Title Company Phone (949) 887-2486 Email Project Information Project Name Type (SFH, Multi -Family, Commercial, Etc.) MADISON CLUB LOT 61 B SFH Location or Street Address 53325 HUMBOLDT BLVD Nearest Cross Streets MERIWETHER WAY Municipality/County/Zip Code La Quinta Tract Number(s) and/or Assessor Parcel Number(s) 33076-2 / LOT 61 779-440-013 Other Location Information Watershed Whitewater River Source Control BMP Information Size of Project Area (nearest 0.1 acre) .82 Project Area managed with Site Design or Low Impact Development (LID) BMPs (nearest 0.1 acre) 82 Is the project subject to onsite retention by City ordinance or policy? NO Name of the Entity that will implement, operate, and maintain the Source Control BMPs Genova Construction & Development Contact Name Joshua Hunter Street or Mailing Address 555 Corporate Dr., Suite 120 City Ladera Ranch Zip Code 92694 Phone (949) 887-2486 T:\Checklists - Forms & Applications\Forms & Applications\GREEN SHEET cover & PM10 less than 1 Acre Revised 9-25-09.doc Check Item To be Performed Source Control BMP Requirements - All Projects Require Non -Structural BMP Source Control Non -Structural BMP (See Appendix H, Section 4.5.2.1) Ongoing Irrigation System and Landscape Maintenance Ongoing Litter Control Ongoing Drainage System Inspection & Maintenance Education/Training for Property Owner, Operators, Occupants, or Employees Activity Restrictions — Prohibition of Debris Blowing/Sweeping/Washing into Street/Storm Drain, Closed Trash Lids, Restriction of Vehicle Washing `/ Ongoing Street Sweeping at Private Streets and Private Parking Lots Check Item To be Provided Source Control BMP Requirements — Small Sloped Lots, Small Commercial, <10 Unit Subdivisions, <5,000 Square Ft. Parking Lots, Etc. Structural BMP (See Appendix H, Section 4.5.2.2) Storm Drain Inlet Stenciling and Signage Landscape and Irrigation System Design to Minimize Erosion & Nuisance Runoff Protection of Slopes and Channels to Minimize Erosion Multi -Family Project Use of Community Car Wash Racks Wash Water Controls for Food Preparation Areas to Use Sanitary Sewer Fueling Area (Design & Maintenance) Including PCC Surface, Canopy & Spill Prevention Air/Water Supply Area Drainage (Design & Maintenance) Including Spill Area Containment Trash Storage Areas (Design & Maintenance) Including Attached Lids, Storm Water Controls ❑ Loading Docks (Design & Maintenance) Including Storm Water Controls, Dry & Frequent Cleaning Procedures Maintenance Bays (Design & Maintenance) Including Indoor Location & Storm Water Containment Vehicle and Equipment Wash Areas (Design & Maintenance) Including Canopy & Containment Outdoor Material Storage Areas (Design & Maintenance) Including Canopy & Containment Outdoor Work Areas or Processing Areas (Design & Maintenance) Including Canopy & Containment ❑ CC&R's, Maintenance Agreements or Other mechanisms will be used to ensure the ongoing operation, maintenance, funding, transfer and implementation of the project -specific WQMP requirements. Legal description and plat stamped by Registered Surveyor to be attached to the applicable CC&R or Maintenance Agreement for recordation at Riverside County. (Optional Requirement to be reviewed on a Project by Project basis) BMP Acknowledgement The applicant shall comply with listed BMPs and applicable provisions of the City's NPDES stormwater discharge permit, Signature: LQMC Sections 8.70.010 et seq. (Stormwater Management and Discharge Controls), and 13.24.170 (Clean Air/Clean Water); Print Name: shwa Hunter Riverside County Ordinance No. 457; the California Regional Water Quality Control Board — Colorado River Basin Region Title: Board Order No. R7-2008-0001 and the State Water Resources Control Board's Order No. 99-08-DWQ. Date: 2 / 1 / 22 Phone: (949 ) 887-2486 T:\Checklists - Forms & Applications\Forms & Applications\GREEN SHEET cover & PM10 less than 1 Acre Revised 9-25-09.doc Applicant Certification certify that I have read this form in its entirety and �i� understand the City's submittal and review process and the Signature. requirements for this form. I understand and agree that if during the processing of the form, it is determined the Print Name: information contains errors or omissions, clarification and/or supplemental information may be required and the Title: preparation of such information may be considered, in the Community Development Director's judgment, an Date: unreasonable delay and will result in a suspension of -2--/-L/9-n22 processing time limits in accordance with the California Code Regulations, Title 14, Section 15109. Phone:(") ��11 2� QI if G,LII/ of - W Owner Certification certify under the penalty of the laws of the State of A� California that I am the property owner of the property that Signature: _ is the subject matter of this application and I am authorizing and hereby do consent to the filling of this application and Print Name: Laura Wellman acknowledge that the final approval by the City of La Quinta, if any, may result in restriction, limitations and construction Title: Owner/ Trustee (Moonbeam Dreams LLC) obligations being imposed on this real property. Date: 2 / 3 /22 Phone: ( 949 855-9111 Mc GEE SUR VEYING, INC. 45-100 Golf Center Pkwy, B1dg.F, Ste.G, Indio, CA 92201 Phone (760) 342-2249 — Fax (760) 342-5044 June 28, 2022 City of La Quinta 78-495 Calle Tampico La Quinta, CA 92253 Re: Form Location — 53-325 Humboldt Blvd. Pursuant to your request a field survey was conducted on the above referenced project to determine the vertical location of the building forms. The above mentioned were found as follows: LOT FORM (DES) FORM (FIELD) DIFFERENCE 61 987.67' 987.67' n/a Setbacks are in general conformance with the approved Architectural Site Plan SincerLAMcGee ay re L.S. 5479 MARK RADFORD ARCHITECTURE 5/31 /23 page 1 of 2 Duane Clayton City of La Quinta Design & Development 78-495 Calle Tamico La Quinta Ca 92253 Plan Check No. BRES2021-0803, 53325 Humboldt RESPONSE TO COMMENTS DATED 5/23/23 Hi Duane, Please find below responses in red below your comments. Responses also includes the following which have been uploaded; 1. revised sheets dated 5/31/23 A4.1, A5.1, M3.0, M3.1, M3.2 & P1.1, 2. Revised Energy Calculations 3. Fireplace installation manuals. Response: SECTION A - GENERAL 1. A separate permit is required for the 16.35kW solar photovoltaic system required per the approved energy calculations for this project. This permit must be obtained prior to the Framing/Rough MEP combination inspection and prior to covering any walls or ceilings. The energy report submitted does not reflect the system size of the solar pv system submitted under application BS01-2023-0084. Please reconcile the discrepancy between the system size proposed in the energy report and the solar pv application. (This is being prepared by others.) 2. Building comment: Provide Planning Division approval for this Project. Please contact Siji Fernandez in the Planning Division directly at (760) 777-7086 with questions regarding the following comment(s): Proposed condenser location may not permissible per Specific Plan (SP 99-035) (1 Have contacted Mr Fernandez and await his response. I believe he wants to visit the site and review the site conditions.) The conditioned living space of the dwelling has been increased in one area and reduced in another; however, the building area does not reflect the change. Additionally, the conditioned space for the dwelling and energy do not coincide with each other. Please address this discrepancy and note that increases in conditioned living space are treated as additions. As Such, this would trigger a new separate permit and revision to building area and school fees. See hallway area near garage and simulator room, and new electrical equipment room as examples. The areas for conditioned space and garage square footage do not reflect this change. (See Project Data sheet A-4.0. The Living area has been reduced by 10 SF. And the garage has been reduced by 39 SF. These areas were reduced by accommodating a 49 sf IID nonliving meter room within the footprint of the structure. SECTION B — PRECISE / SITE PLAN / ZONING 1. No comments. 2282 Via Cascabel * ESCONDIDO * CA * 92027 * (760)432-0348 5/31 /23 page 2 of 2 Plan Check No. BRES2021-0803, 53325 Humboldt RESPONSE TO COMMENTS DATED 5/23/23 CONTINUED SECTION C -ARCHITECTURAL 1. Specify the make, model number, and ICC Evaluation Report Number (or UL Listing Number) of factory -built fireplaces and/or wood stoves. (CRC §R106.1.1) Proposed gas fireplaces shall be a direct -vent sealed combustion type and have provided a current copy of its specifications and listing report to demonstrate compliance. (CALGreen §4.503.1) (The make and model numbers are on the floor plan sheet A-5.1 and fire place notes at the bottom of the sheet A-5.1. The installation manuals have been uploaded.) 2. Provide note on plans stating that the proposed fireplaces, decorative gas appliances or gas log will be provided with the following: (CEnC §150.0(e)) a) Closable metal or glass doors covering the entire opening of the firebox; b) A 6-square inch combustion air intake with readily accessible, operable and tight -fitting damper; and c)A flue damper with a readily accessible control (The note above has been added to the Floor Plan, see fireplace notes bottom of sheet A- 5.1) SECTION D — MECHANICAL 1. No comments. SECTION E — ELECTRICAL 1. No comments. SECTION F — PLUMBING 1. Revise isometrics to reflect additional fixture outlets for this revision. ( The plumbing plan has been revised, see sheet P1.1) SECTION G — ENERGY EFFICIENCY 1. Conditioned floor area on Plans does not match energy calculations. See section A, General, #3 above. (The Energy Calculations have been revised to reflect the reduced living and garage areas.) (see revised Calculations and sheets M3.0, M3.1 & M3.2) 2. Informational Items: Conditioned floor area (CFA) is the total floor area (in square feet) of enclosed conditioned space on all floors of a building, as measured at the floor level of the exterior surfaces of exterior walls enclosing the conditioned space. [§101.1] This term is also referred to in the standards simply as the floor area. This is an important value for the purpose of compliance since annual energy use is divided by this value to obtain the energy budget. CFA is calculated from the plan dimensions of the building including the floor area of all conditioned and indirectly conditioned space on all floors. It includes lofts and mezzanines but does not include covered walkways, open roofed -over areas, porches, pipe trenches, exterior terraces or steps, chimneys, roof overhangs or parking garages. Unheated basements or closets for central gas forced air furnaces are also not included unless shown to be indirectly conditioned. The floor area of an interior stairway is determined as the CFA beneath the stairs and the tread area of the stairs themselves. (Residential Compliance Manual §1.8 Conditioned Floor Area) (Understood areas have been revised.) SECTION H — CALGREEN 1. No comments. SECTION I - STRUCTURAL 1. No comments, structural review has been approved. SECTION J — SOIL / FOUNDATION 1. No comments. SECTION K - MISCELLANEOUS COMMENTS 1. No comments. If you have any questions feel free to call my cell 760 519-9008 Regards, Mark Radford 2282 Via Cascabel * ESCONDIDO * CA * 92027 * (760)432-0348 Duane Clayton From: Karl Voigtlander <karl.mra@sbcglobal.net> Sent: Wednesday, March 15, 2023 8:00 AM To: Duane Clayton Subject: Fw: BRES2021-0803 - 53325 HUMBOLDT Follow Up Flag: Follow up Flag Status: Flagged EXTERNAL: This message originated outside of the City of La Quinta. Please use proper judgement and caution when opening attachments, clicking links or responding to requests for information. Duane Below is a description of the changes I just uploaded to Etrakit from the contractor please let me know if you need anything else. Thanks, Karl Voigtlander Mark Radford Arch. Escondido, Ca. 92027 cell 760 877-8248 ----- Forwarded Message ----- From: Jon Foster <jon@genovacd.com> To: Karl Voigtlander <karl.mra@sbcglobal.net>; Don Dea <don@genovacd.com>; Mark Radford <markarc@sbcglobal.net>; Tony Hranek <resstruct@gmail.com> Sent: Wednesday, March 15, 2023 at 07:50:46 AM PDT Subject: Re: Fw: BRES2021-0803 - 53325 HUMBOLDT Karl, This is the description: The owner wanted the Condenser units to be off of the ground. We relocated the Condenser units to the roof area above the Entry, above trusses L3-L8. The truss Designer has labeled the location of the Condenser pad contact support points above these trusses, along with the maximum weights allowed per the truss calculations. The Engineer of record has reviewed these trusses with the Condenser loads, and has approved this design with the Engineering Stamp. The Air Handlers were originally to be installed in the Attic space throughout the house. Once we determined the spray foam insulation thickness, we decided it would be best for future service, to relocate the Air Handlers to the roof. The Architect designed "Air Handler" rooms up on the roof, and support shelves where necessary to stack the units. The Engineer of Record reviewed this design, and has approved this additional wall and shelf system with the Engineering Stamp. These rooms are only a 6-6" extension from the original Parapet wall. Visually, the stone and stucco is only a minimal change that really cannot even be seen from the ground. The Air Handler Room changes should have already been uploaded. Please let me know if you need any additional information. Thank you, Jon Foster On Tue, Mar 14, 2023 at 4:04 PM Karl Voigtlander <karl.mra(a�sbcglobal.net> wrote: Jon the city is requesting written description of what i just uploaded see email below. Thanks, Karl Voigtlander Mark Radford Arch. Escondido, Ca. 92027 cell 760 877-8248 ----- Forwarded Message ----- From: Karl Voigtlander <karlwv(c�gmail.com> To: Karl Voigtlander <karl.mrasbcglobal.net> Sent: Tuesday, March 14, 2023 at 04:03:30 PM PDT Subject: Fwd: BRES2021-0803 - 53325 HUMBOLDT Karl Voigtlander 760 877-8248 ---------- Forwarded message --------- From: Duane Clayton <dclayton laquintaca.gov> Date: Tue, Mar 14, 2023 at 3:47 PM Subject: BRES2021-0803 - 53325 HUMBOLDT To: karlwv(a)gmail.com <karlwv(c�gmail.com> Good Afternoon, An incomplete plan submittal was received this afternoon for the project at 53325 Humboldt Blvd, in the Madison Club. Please be sure to include a written description of the proposed alterations. Additionally, any alternate details, or revised plans should have the preparer's or engineer's stamp and signature as needed. Please reach out with any questions on the project. Thank you. I W — CALIFORNIA — Jon Foster GENOVA CONSTRUCTION I DEVELOPMENT 555 Corporate Dr., Suite 120 Ladera Ranch, CA 92694 c: 760-275-5189 e: Jon(a-)genovacd.com Duane Clayton I Plans Examiner Design & Development City of La Quinta 78495 Calle Tampico I La Quinta, CA 92253 Ph. 760.777.7084 www.laquintaca.gov www.plaVinlaguinta.com OUTDOOR UNIT 1•)(b) 4TWV8048AI0008 POWER CONNS.—V/PH/HZ" 208/230/l/60 MIN. BRCH. CIR. AMPACM 28.0 OR. CIR. PROT. RTG. — MAX. (AMPS) 40 COMPRESSOR SCROLL NO. USED NO, SPEEDS 1-VARIABLE R.L. AMPS 'a — L.R. AMPS 20.3 — 12.0 FACTORY INSTALLED START COMPONENTS,, NA INSULATION/SOUND BLANKET YES COMPRESSOR HEAT YES OUTDOOR PAN DIA. (IN.) — NO. USED 27.5 — 1 TYPE DRIVE — NO. SPEEDS DIRECT— VARIABLE CFM O O.D IN. W.G. ' 4467 NO. MOTORS —HP 1 — 1/3 MOTOR SPEED R.P.M, 200 — 1200 VOLTS/PH/HZ 208/230/1160 F.L. AMPS 2.8 OUTDOOR COIL —TYPE SPINE FIN" ROWS — F.P.I. 1- 24 FACE AREA (SQ. FT.) 27.87 TUBE SIZE (IN.) 3/8 REFRIGERANT R410-A LBS. — R-410A O.D. UNIT) 4'. 101b — 8 oz FACTORY SUPPLIED YES LINE SIZE — IN. O.D. GAS 1, 7/8 LINE SIZE — IN. O.D. LIQ. "" 3/8 CHARGING SPECIFICATIONS SUBCOOLING to - DIMENSIONS H X W X D CRATED (IN.) 46.4 x 35.1 x 38.7 WEIGHT SHIPPING (LES.) NEr(LBS.) 234 • Certified in accordance with the Air Source Unitary Air- oner Equipment Certlficatlon program, Which is based on AMR[ standard 210/240. ^' Rated in accordance with AHRI standard 270. Calculated in accordance Witt) Nat], Elec. Codes. Use only HACK Circuit breakers or fuses. 'T This value shown for compressor RLA on the unit nameplate and on this specification sheet Is used to compute minimum branch circuit ampeci[Y and maxfuse sae. The value shown is the branch circuit selection current. NA means no start components. Yes means quick start kit components. PTC means positive temperature coefficient starter. Standard Air -- Dry Cod - Outdoor This value approximate. For more precise value see unit nameplate. ^' Max. linear length 150 ft.; Max. lift - Suction 50 ft.; Max. lift -- Liquid SO ft. Mechanical Sr Options General This unit is designed to temperatures from 55e F 109 F to 660 F in heating approved indoor match) these models. ComfortLink"' It This outdoor unit contai communication with 2 v Plug-n-Play set up. Casing Unit casing is constructs galvanized steel and pal powder paint on all loud other panels. Corrosion DuraTuff" base. Refrigerant Controls Refrigeration system co compressor contactor al switches. A factory sup) standard. Compressor Inverter driven scroll col output capacity on heat capacity on air conditior minimizes sound levels protection protects com speed and current draw protecting the comprest Condenser Coil The Spine Fin'v outdoor resistance and efficient I Protected on all four sid Low Ambient Cooling As manufactured, this s' protection that will allov but will reduce capacity prevent operation under Comfort Control The 10501950/850 Contr( Plug-n-Play setup and 3 4TWV8048A-SUB-ID-EN RTIFICATE OF OCCUPANCY DESIGN AND DEVELOPMENT DEPARTMENT This Certificate is issued pursuant to the requirements of Chapter 1 Section R110 of the California Residential Code, certifying that, at the time of issuance, this structure was in compliance with the provisions of the Building Code and the various ordinances of the City regulating building construction and/or use. BUILDING ADDRESS: 53325 HUMBOLDT BLVD Use Classification: Building Residential Permit No.: BRES2021-0803 Occupancy Group: U: Utility/Misc Type of Construction: V-B Land Use Zone: RL Structures/ R-3: 1 & 2 Family Dwellings Code Edition: 2019 Sprinkler Installed: YES Sprinkler Required: YES By: Edward Ghera Owner of Building: MOONBEAM DREAMS LLC Date: 4/23/2024 12:00:OOAM Address: 27412 ALISO VIEJO PRKWY Building Official: AJ ORTEGA City, ST, ZIP: ALISO VIEJO, CA 92656 �Q�(v GEM ofthe DESERT — POST IN A CONSPICUOUS PLACE